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Case management programs

In certain health situations, members are eligible to work one-on-one with a case manager. You may be eligible for a case manager if you:

• Have a qualifying complex, chronic disease
• Are at risk for developing a complex and serious medical condition (This may be determined by your answers to the Health Risk survey that you completed during enrollment.)
• Have been involved in an accident or other catastrophic health event
• Need assistance managing your health care needs

Case managers are available at no additional cost, but copayment and coinsurance for covered services may apply. Case managers can help you:

• Navigate the health care system
• Identify, implement and monitor your health care needs
• Learn how to prevent falls
• Eliminate barriers to receiving care
• Learn more about your disease, benefits and medications
• Find resources in your community
• Coordinate services such as home health, skilled nursing facilities, inpatient rehabilitation, hospice, durable medical equipment, transplants and more.

To request services from a Blue Medicare HMO or Blue Medicare PPO case manager, please contact Customer Service 7 days a week, 8am to 8pm:

Blue Medicare HMO

1-888-310-4110

Blue Medicare PPO

1-877-494-7647

For the hearing and speech impaired

1-888-451-9957 (TTY/TDD)

Seven days a week
8 a.m. - 8 p.m.

Blue Medicare HMO and Blue Medicare PPO plans are offered by PARTNERS National Health Plans of North Carolina, Inc. (PARTNERS), a subsidiary of Blue Cross and Blue Shield of North Carolina (BCBSNC). PARTNERS is a Medicare Advantage organization with a Medicare contract to provide HMO and PPO plans. Plans are administered by BCBSNC. BCBSNC and PARTNERS do not discriminate based on color, gender, religion, national origin, age, race, disability, handicap, sexual orientation, genetic information, source of payment or health status as defined by the Centers for Medicare & Medicaid Services (CMS). All qualified Medicare beneficiaries may apply. You must be entitled to Medicare Part A and enrolled in Medicare Part B and must reside in the CMS-approved service area. You must continue to pay your Medicare Part B premium, if not otherwise paid for under Medicaid or another third party. BCBSNC and PARTNERS are independent licensees of the Blue Cross and Blue Shield Association.

The information on this page is current as of 11/4/08.